Provider Demographics
NPI:1558828756
Name:BRADY, NATALIE (MED, LICSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:MED, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 PLEASANT ST STE B265
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3900
Mailing Address - Country:US
Mailing Address - Phone:413-320-0866
Mailing Address - Fax:
Practice Address - Street 1:351 PLEASANT ST STE B265
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3900
Practice Address - Country:US
Practice Address - Phone:413-320-0877
Practice Address - Fax:617-616-0248
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1222351041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1740867993OtherNPI2